Senior Technical Specialist (Coordination of Benefits)

Overview

Cotiviti Healthcare is a leading provider of payment accuracy services to the most recognized companies in the healthcare and retail industries. We are seeking innovative thinkers and creative problem solvers who are interested in making a contribution to improving healthcare and want to be part of a team that is expanding rapidly and providing opportunities for career growth. If you want to make a difference and contribute to the improvement of healthcare payment integrity, consider an opportunity to join our healthcare recovery team as a Senior Technical Specialist.

 

This role is part of our Coordination of Benefits (COB) team, and will be responsible for working with product owners and technical architects to define project scope, technical direction, and project milestones. You will have responsibility for working with other stakeholders to define business requirements, acceptance criteria and non-functional requirements consistent with SAFe (Scaled Agile Framework). You will also handle tracking of project deliverables, as well as issue, change and release management for implementation of desired functionality. You will need to have the ability to execute cross functional tasks in a matrix environment.

 

The STS will also perform quality assurance testing, acceptance criteria sign off and accompanying documentation. Additional responsibilities to include product demo, presentation, and training.

Responsibilities

• Plan and schedule project timelines and milestones using appropriate tools. Participate in refinement of existing products, product development process and operational UAT sessions.
• Lead and manage cross functional, matrixed project teams in day-to-day activities necessary to successfully complete the project according to objectives and within deadlines.
• Serve as a subject matter expert and resource for training and internal stakeholders.
• Learn and execute established processes. Suggest, refine, and document improvements to said established processes.
• Coordinate and actively participate in all stages of project development including research, design, programming, testing, and implementation.
• Coordinate meetings, agendas, and track action items across Business Units.
• Work closely with technical product owners, architect, and engineers to groom business requirements and acceptance criteria consistent with SAFe events.
• Complete all responsibilities as outlined in the annual performance review and/or goal setting.
• Complete all special projects and other duties as assigned.
• Must be able to perform duties with or without reasonable accommodation.

Qualifications

Requirements:

• Bachelor’s degree or equivalent experience.
• 5+ years of experience leading project focused initiatives in a cross functional matrix.
• Knowledge of IT applications, and medical claims processing.
• Prior experience in the healthcare industry.
• Strong understanding of data structures, data processing, data integration, and experience with SQL, Python, or Spark is a plus.
• Prior experience with medical claims processing.
• Experience in developing, implementing, and maintaining project plans, including task breakdown and work assignments.
• Ability to speak and present with authority, knowledge, and confidence to stakeholders. Must be able to adjust well to new situations and changing priorities and be motivated and able to thrive in a fast-paced environment.
• Autonomous and solution-oriented, with a strong customer service ethic.
• Familiarity working with multiple software and data applications, including proficiency in the MS Office Suite.
• Experience working on new development and services, healthcare data subject matter, Scaled Agile methodologies.

Cotiviti Inclusive Desired Experience:

• Technical knowledge and experience working with Cotiviti technologies and applications. (Decipher, CE2, Python, Spark, MS Access, Hadoop, HDFS, JIRA, Asana).
• Client data analysis and mapping.
• Content subject matter expertise (SME) across a wide range of clients.
• Strong auditing skills and best practices.
• Audit management workflow and process orientation.
• Experience working with solutions across multiple clients, teams within COB, and Data Mining.

Mental Requirements:

• Troubleshooting: The ability to diagnose and solve complex technical issues, often under pressure. Technical Specialists must quickly identify the root cause of problems and find effective solutions.
• Critical Thinking: Specialists are expected to assess a situation, evaluate possible solutions, and make decisions based on logic and